Cancer incidence in the African population of Harare, Zimbabwe: Second results from the cancer registry 1993–1995

Chokunonga, Eric; Lévy, L.; Bassett, Mary T.; Mauchaza, B.G.; Thomas, David B.; Parkin, Donald Maxwell

doi:10.1002/(sici)1097-0215(20000101)85:1<54::aid-ijc10>3.0.co;2-d

Cited by 130 publications

(70 citation statements)

References 20 publications

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“…All forms of KS are associated with infection by human herpesvirus 8 (HHV8) (5,6). AIDS-associated KS is particularly aggressive, and it is one of the principal neoplasms in regions of Africa affected by both high endemic HHV8 and epidemic HIV infection (7).…”

Section: Kaposi's Sarcoma (Ks)mentioning

confidence: 99%

HIV-1-Tat Protein Activates Phosphatidylinositol 3-Kinase/ AKT-dependent Survival Pathways in Kaposi's Sarcoma Cells

Deregibus¹,

Cantaluppi²,

Doublier³

et al. 2002

Journal of Biological Chemistry

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In this study we found that Tat protected vincristinetreated Kaposi's sarcoma cells from apoptosis and from down-regulation of several anti-apoptotic genes such as AKT-1, AKT-2, BCL2, BCL-XL, and insulin-like growth factor I and induced the de novo expression of the interleukin-3 gene. Moreover, we found that Tat enhanced phosphorylation of AKT and BAD proteins. The inhibition of phosphatidylinositol 3-kinase with two unrelated pharmacological inhibitors, wortmannin and LY294002, abrogated both the anti-apoptotic effect and the phosphorylation of AKT induced by Tat. After treatment with Tat, the AKT enzymatic activity showed a biphasic increase: an early activation (15 min), independent from protein synthesis; and a delayed activation (24 h), which was significantly decreased upon blockage of protein synthesis. Experiments with a function blocking antivascular endothelial cell growth factor receptor-2 antibody suggested that both the early and delayed AKT activation and the protection from apoptosis were triggered by the interaction of Tat with vascular endothelial cell growth factor receptor-2. Moreover, experiments with function-blocking antibodies directed against insulin-like growth factor I/insulin-like growth factor I receptor or interleukin-3 indicated their involvement in the delayed activation of AKT and their contribution to the anti-apoptotic effect of Tat on vincristine-treated Kaposi's sarcoma cells.

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Section: Kaposi's Sarcoma (Ks)mentioning

confidence: 99%

HIV-1-Tat Protein Activates Phosphatidylinositol 3-Kinase/ AKT-dependent Survival Pathways in Kaposi's Sarcoma Cells

Deregibus¹,

Cantaluppi²,

Doublier³

et al. 2002

Journal of Biological Chemistry

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“…In Zimbabwe, however, the incidence of EKS has over the last 2 decades continued to rise. 5,6 EKS, the most common male tumor, now accounts for 41% of all tumors observed in black Zimbabweans. The age-standardized rate (ASR) for men rose from 24.4/100,000 in 1990 -1992 to 47.2/100,000 in 1993-1995.…”

mentioning

confidence: 99%

“…EKS is currently the leading childhood tumor between the ages of 1-14 years, having overtaken retinoblastoma and leukemias. 5,6 Unlike endemic Kaposi's sarcoma, which responds well to treatment 7 and has long-term disease-free survival, EKS responds poorly to most forms of therapy because of the severe underlying immunodeficiency. Without access to HAART, the goal of treating EKS is palliation, and therefore quality of life (QOL) of patients is of paramount importance.…”

mentioning

confidence: 99%

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Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: Results of a randomized quality of life focused clinical trial

Olweny¹,

Borok

Gudza

et al. 2004

Int. J. Cancer

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Kaposi's sarcoma is currently the most common tumor in Zimbabwe. The purpose of our study is to compare the effectiveness of supportive care vs. 3 intervention approaches, namely oral Etoposide, a 3-drug combination, and radiotherapy using quality of life (QOL) as the primary measure of success. In addition, our study was to determine whether a disease-specific module has greater sensitivity to group differences than a generic QOL questionnaire and to determine the most pragmatic approach to treating epidemic Kaposi's sarcoma (EKS) in Zimbabwe. In addition, on the physical and psychological subscales, the Etoposide group had a significantly better QOL than the other 3 treatment groups (p < 0.04). The 3-drug combination, supportive care and radiotherapy groups did not differ significantly from each other with respect to the total FLI-C score or its subscales. There were no group differences with respect to survival. Oral Etoposide therapy resulted in better total FLI-C QOL score than radiotherapy. As well, Etoposide resulted in better physical and psychological subscale scores than radiotherapy, 3-drugs and supportive care. Thus, funds permitting, oral Etoposide is a pragmatic approach to treating EKS in an environment where antiretroviral drugs are not universally available. The study underscores the value of undertaking studies in areas of disease prevalence and the necessity of selecting appropriate outcome measures.

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“…Data from the Zimbabwe National Cancer Registry (ZNCR) (Chokunonga et al, 2000;Parkin et al, 2003) were used. The registry, established in 1985, covers the population of the Zimbabwean capital, Harare.…”

Section: Data Setmentioning

confidence: 99%

Calculating age-adjusted cancer survival estimates when age-specific data are sparse: an empirical evaluation of various methods

Gondos¹,

Parkin

Chokunonga

et al. 2006

Br J Cancer

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We evaluated empirically the performance of various methods of calculating age-adjusted survival estimates when age-specific data are sparse. We have illustrated that a recently proposed alternative method of age adjustment involving the use of balanced age groups or age truncation may be useful for enhancing calculability and reliability of adjusted survival estimates. Age adjustment is widely used in studies comparing survival of different cancer patient populations. Most commonly, the comparison is made by calculating a weighted average of agespecific survival estimates, using weights reflecting the age distribution of some defined standard population. There has, however, been a large diversity in the practice of age adjustment, mainly concerning the definition, the number and width of the age groups, and methods to overcome difficulties when the agespecific survival could not be calculated. Such situations are not uncommon in comparative survival studies, particularly when data for rare cancers or data from registries covering smaller populations is involved. Examples of the practice of age adjustment of cancer survival are given in Table 1.Recently, an alternative method was proposed for age adjustment of survival estimates , in which weights are assigned to the patients before one carries out the survival analysis. Weights are determined as the percentage of patients in the age group the patient belongs to in the standard population divided by the corresponding percentage in the study population. Survival analysis is carried out using the weighted individual data, without the need to calculate age-specific survival estimates .In this paper, we empirically evaluate and compare the performance of different options of age adjustment methods in situations when age-specific data are sparse. MATERIALS AND METHODS Data setData from the Zimbabwe National Cancer Registry (ZNCR) (Chokunonga et al, 2000;Parkin et al, 2003) were used. The registry, established in 1985, covers the population of the Zimbabwean capital, Harare. In terms of operational circumstances, which have been described in detail elsewhere, the registry may be considered as a typical example for an urban developing country cancer registry with appropriate data quality outcomes (Sankaranarayanan et al, 1998;Parkin et al, 2003;Chokunonga et al, 2004). Survival results for a large number of cancer sites were recently published elsewhere (Gondos et al, 2004).We assessed various options of age adjustment of 5-year survival estimates among patients diagnosed with five different types of cancers in 1993 -1997 and followed up until 31 December 1999: skin melanomas, breast, cervical and prostate cancer and lymphomas. Breast and cervical cancers were included because they were represented by relatively large samples. Prostate cancer, for which only 3-year survival could be calculated due to the lack of patients with a 5-year follow-up time, was included because of the unusual age distribution (high proportions of older patients). Lymphomas were included becau...

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Cancer incidence in the African population of Harare, Zimbabwe: Second results from the cancer registry 1993–1995

Cited by 130 publications

References 20 publications

HIV-1-Tat Protein Activates Phosphatidylinositol 3-Kinase/ AKT-dependent Survival Pathways in Kaposi's Sarcoma Cells

HIV-1-Tat Protein Activates Phosphatidylinositol 3-Kinase/ AKT-dependent Survival Pathways in Kaposi's Sarcoma Cells

Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: Results of a randomized quality of life focused clinical trial

Calculating age-adjusted cancer survival estimates when age-specific data are sparse: an empirical evaluation of various methods

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